[Clinical and Therapeutic Profile and Outcomes of Patients with Tuberculosis at the Regional Hospital of Tahoua, Republic of the Niger]. / Profil clinique, thérapeutique et évolutif de la tuberculose au centre hospitalier régional (CHR) de Tahoua, république du Niger.

This study aims to describe the epidemiological, clinical, therapeutic characteristics of patients followed for tuberculosis at the Regional Hospital Center of Tahoua (Niger) as well as their outcomes.We conducted a retrospective and descriptive study from the medical records of patients followed for tuberculosis between January 1, 2017 and December 31, 2019. A total of 465 patients were included in the present study (304 men and 161 women; mean age: 30 years). Patients coming from urban areas represented 51% of the cases. Bacteriologically confirmed pulmonary tuberculosis represented 63% of the cases, 15% of clinically diagnosed pulmonary tuberculosis and 22% of extrapulmonary tuberculosis including Pott's disease. The HIV testing rate was 97.8%. Tuberculosis-HIV association represented 13% of the cases. The therapeutic success was 90.5%. The lethality rate was 5.2% (24/465). Among 24 patients who died, three had tuberculosis-HIV association.

L'objectif de cette étude était de décrire le profil clinique, thérapeutique et évolutif des patients suivis pour tuberculose (TB) au centre hospitalier régional de Tahoua (Niger). Nous avons mené une étude rétrospective, descriptive à partir des dossiers des patients suivis pour TB entre le 1er janvier 2017 et le 31 décembre 2019. Au total, 465 patients ont été inclus dans la présente étude (304 hommes et 161 femmes, âge moyen : 30 ans). Les patients provenant du milieu urbain représentaient 51 % des cas. La TB pulmonaire confirmée bactériologiquement représentait 63 % des cas, la TB pulmonaire cliniquement diagnostiquée 15 %, la TB extrapulmonaire, notamment le mal de Pott, 22 %. L'association TB­VIH représentait 13 % des cas. Le succès thérapeutique était de 90,5 %. Le taux de létalité était de 5,2 % (24/465). Parmi les 24 patients décédés, trois présentaient l'association TB­VIH.

Inflammatory demyelinating diseases of the central nervous system in Niger.

BACKGROUND: In sub-Saharan Africa (SSA), few studies have been reported on inflammatory demyelinating diseases of the central nervous system (CNS). Neuromyelitis optica spectrum disorders (NMOSD) seems to be the most frequent inflammatory demyelinating disease of CNS in sub-Saharan Africans or people of sub-Saharan African descent. METHODS: We report the observations of seven patients from Niger diagnosed with inflammatory demyelinating diseases of CNS over a period of 21 years (1996-2017). RESULTS: They were four women and three men aged 19 to 66 years (mean age: 37 years), with no known past medical history. Four patients were diagnosed with NMOSD (2 men and 2 women) and the three other patients with multiple sclerosis (MS, 2 women and 1 man). The three patients diagnosed with MS had the relapsing-remitting form. The cerebrospinal fluid study revealed the presence of oligoclonal bands in the three patients. Of the patients diagnosed with NMOSD, two patients negative anti-aquaporin 4 antibodies (anti-MOG antibodies not done), one of whom had bilateral optic neuritis (ON) with longitudinally extensive transverse myelitis (LETM) and the other unilateral ON with LETM. Two patients with MS were treated with interferon beta-1a and the third patient with azathioprine. The Expanded Disability Status Scale ranged from 1 to 2 in these three patients at the time of initiation of background treatment. Azathioprine was the treatment prescribed in the four patients with NMOSD. We did not find any case of acute disseminated encephalomyelitis. CONCLUSION: Our case series suggests the rarity of inflammatory demyelinating diseases of CNS in Niger, and NMOSD seems to be more frequent than MS.

First documented case of Devic's neuromyelitis optica in Niger

Devic's neuromyelitis optica is a chronic inflammatory demyelinating disease of the central nervous system that mainly affects spinal cord, optic nerve and brain regions with high aquaporin 4 antigen expression. We report the first documented case of Devic's neuromyelitis optica in Niger. It was a 66-year-old black man who had presented a rapidly progressive flaccid tetraplegia associated with vesico-sphincteral disorders, in whom magnetic resonance imaging had shown longitudinally extensive transverse cervical myelitis with positive anti-NMO antibodies